Seattle’s Pacific Health Summit, the “Davos” of Global Health, Zeroes in on Tuberculosis
Movers and shakers in global health—including a lot of people not named Bill & Melinda—will be buzzing around the Seattle waterfront this week for what some people like to call the “Davos” of global health.
Like the World Economic Forum in Davos, Switzerland—another picturesque setting with mountains and water nearby—the Pacific Health Summit is an invitation-only annual conference of about 250 world leaders in science, politics, and business. This year, they are gathering to brainstorm about how to put a dent in one of the world’s deadliest infectious diseases: tuberculosis.
The list of power brokers appearing on the docket includes: Margaret Chan, director-general of the World Health Organization; Chris Viehbacher, CEO of drug and vaccine giant Sanofi-Aventis; Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases; and Paul Farmer, founding director of Partners in Health, the famed physician to people in poor countries. Big Pharma will be well-represented by the likes of Merck, GlaxoSmithKline, Johnson & Johnson, Bayer, and others.
The main theme of discussion, TB, rarely captures the attention of the masses, like, say, swine flu does. But it’s at least as worrisome, and it’s not going away. The disease, caused by a bacterial invader that attacks the lungs, is characterized by a chronic cough that makes it especially contagious. There is no vaccine, diagnostics aren’t very accurate, and no new drug has been developed in decades, as Farmer put it in a recent appearance in Seattle. That adds up to a pretty grim outlook for a lot of people. About one in three people on Earth (2 billion cases) are estimated to be infected, and TB kills 1.5 million people a year—ranking it right up there with HIV and malaria as one of the world’s leading killers.
“With TB, there have been no new drugs for 40 years,” says Michael Birt, the executive director of the Pacific Health Summit, and senior vice president for health and society affairs at the National Bureau of Asian Research. “Industry can and should contribute more.”
This field has traditionally been plagued by a classic free market failure. No new drugs get developed because the potential profits in selling a drug to poor people don’t justify the risk and expense of R&D the way afflictions of wealthy countries, like cancer and diabetes, do.
Birt was quick to challenge my assertion about TB being a disease of the developing world, though. In the age of jet travel, an attorney from Atlanta can get infected with an extensively drug-resistant form of TB and can get on a plane and go to Europe and back, potentially infecting others—and causing public health authorities to get seriously worried. Seattle has also had its share of notorious TB cases, including a diagnosis in 2001 of former Mariners shortstop Carlos Guillen during the September stretch run of the memorable 116-win season.
So just like any infectious bug, TB can cross borders pretty fast and cause trouble in our neighborhood. Then again, there’s a reason that the American public has forgotten about TB. The incidence rate in Washington state reached an all-time low of 3.5 cases per 100,000 people in 2008, according to the Washington state Department of Health.
Since Xconomy is focused on innovative new solutions, I asked Birt and the summit’s project director, Claire Topal, to point to some of the most intriguing TB treatments emerging in the pharmaceutical industry pipeline. One that popped to mind was TMC207, in development by Johnson & Johnson. This drug, which recently showed promising results in a mid-stage clinical trial, is thought to have potential because it’s highly potent against drug resistant strains of TB, researchers say.
And just on the other side of the building from Xconomy’s Seattle office, there’s another intriguing effort underway. It’s the Lilly TB Drug Discovery Initiative, a program sponsored by Eli Lilly at the Infectious Disease Research Institute. This is a small group of scientists who formerly worked together at Bothell, WA-based Icos, who received $9 million of donated equipment for high-speed screening of drug candidates. Lilly has opened up access to its library of 500,000 small-molecule chemical compounds to be screened as TB drug candidates, and Lilly donated $6 million in cash over the next five years to do the work.
The work is still at an early stage, although “there has been a lot of progress,” says Steve Reed, the founder and head of research and development at IDRI. One drug candidate donated from a research group in Japan has shown particular promise in fighting multidrug resistant TB in mice, he says, and scientists are working to optimize the compound for use in humans, he says. The goal will be to come up with a number of drugs like this that can be potent single agents on their own, which would simplify the course of treatment and give doctors a number of tools to throw at the bug.
“You want to have an arsenal,” Reed says.
Reed plans to attend the Pacific Health Summit. I asked him what he hopes to accomplish. “Networking,” he says. “It’s important to initiate new collaborations, and bring visibility and funding. I hope more pharmaceutical companies get more interested.”